Individual
DR. WILLIAM FREDERICK KORTUM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3414 MOSS ST STE A, LAFAYETTE, LA 70507-6107
(337) 235-1212
Mailing address
3414 MOSS ST STE A, LAFAYETTE, LA 70507-6107
(337) 235-1212
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
027100
LA
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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